Ultimate Survey

Interventional Pain Needs at CMH
Page 1 of 8

Questionnaire for CMH providers regarding their perceived usage and needs for interventional pain management.

Thank you for participating in this survey. We hope to learn about interventional pain needs across the hospital and clinics, so that we can best determine how to grow our overall pain program.

For this survey, we separated interventions into four categories:
Spinal interventions (e.g. facet injections, epidural injections, transforaminal injections, indwelling catheters)
Other blocks (e.g. occipital, trigeminal, intercostal, stellate ganglion, celiac plexus)
Other injections (e.g. trigger point, steroid joint injections, synovial fluid replacement)
Implanted devices (e.g. intrathecal pumps, spinal cord stimulator)

We will be asking about:
1. Procedures for which you might refer (and general indications)
2. Potential yearly frequency of these procedures
3. Where you current send these patients
4. Barriers to having them treated at CMH
5. Barriers to external referral

Please answer only about your own patients, not about your whole clinic or Section. We will try to survey everybody in the hospital and clinics who may refer for these procedures.